Anyone had a synacthen test?

[RealLifeClanger]

Has anyone had a synacthen test? My GP referred me for one and it's booked for tomorrow. I've just found out that my partner will now not be around afterwards as planned (has to go to a wake) and I don't know whether to go ahead with it. No one else can come to the appointment with me either so I'd have to go alone and I have my children to pick up from school and look after when I get back. I have read that hypersensitive reactions can happen so I'm worried about side effects.

My 8-9am cortisol was 234 in March and 322 in April, which apparently is indeterminate for Addisons disease, hence the test. Although I've just read that over 300 is normal for 8-9am Cortisol so I'm confused now! My appointment is at 11am, which sounds like it's too late for the synacthen test anyway from what I've read. Can anyone shed any light on any of this? I don't know whether to just postpone until a better time or I even need one at all.

I’ve had a couple with absolutely no problems at all. I attended on my own, and didn’t consider taking anyone with me. (I don’t have a partner but have done it on my own anyway) With kindness, the test itself is a very easy thing to have and I wasn’t advised about sensitivities at all. Perhaps that’s why I didn’t worry beforehand!
please try not to worry,

Not me, but my young child has, and it was fine. No issues and I think we went for ice cream on the way home.

I’ve had one and I couldn’t have driven afterwards but I also couldn’t drive before hand as I was seriously unwell and could barely stand unaided . My cortisol was 33 and I do have primary Addisons . If you are ok to get to the appt under your own steam you should be fine to get home again .

DD had it about 10 years ago aged 16. I dropped her at school straight afterwards.
She hadn't been 100%, a problem was flagged due to lower than expected cortisol as part of a full blood screening to rule out other health issues when she was suffering from anxiety and depression. She does have Addisons. She manages it, along with her anxiety and depression. She was lucky to have a good physician and didn't get so ill she entered into crisis.

@RealLifeClanger just crack on with it. Sooner it's done, sooner it's over. There's not much to it. It goes into a muscle I think but dd said it was fine.

Thanks all, I had it today and it was largely uneventful. I just panicked a bit and felt off due to that. Just got to await results now!

If you’ve failed you should hear pretty quickly , I had mine privately and the results were back on the same evening but I’d already started on hydro / fludro anyway .

I have Addisons disease. I have undetectable cortisol levels. Zero. Usually if you fail the sst you will know very quickly. Your morning levels are low but not shockingly low so try not to worry in the meantime. We have a very active group on Facebook you can join for advice - UK Addisons disease and AI support group. Link here -

https://www.facebook.com/share/g/1Xt2s1NgBo/?mibextid=wwXIfr

Thank you both, I'm hoping it's not Addisons obviously but I am slightly worried. I've never had adrenal crisis though. I suspect it's secondary to something else but what that something is I don't know!

@RealLifeClanger I’d not gone completely into crisis prior to diagnosis , was very ill and had been hospitalised but I was totally mismanaged by the NHS , sent home unable to stand for more than 3/4 steps with a bp of 80/50 that dropped to 65/ when I stood up . I had a private consultation 2 days post discharge and was diagnosed that way .

Not everyone with Addisons / adrenal insufficiency will have a crisis - ever. I was very ill for 18 months prior to diagnosis and was diagnosed with undetectable cortisol levels but unbelievably I never had a crisis. They only occur when something pushes the need for cortisol over what the body can provide (either through its own making or steroids) - ie illness, stress, etc etc. I was diagnosed in 2017 and I’ve had 2 full crises since, both related to lupus related infections.

There are different types and causes of adrenal insufficiency. This link may be helpful -

https://www.addisonsdisease.org.uk/what-is-addisons-disease

It's a simple uninvasive test. I've done it twice. I drove to hospital and back myself both times.

I don't have Addison's so people who have that will feel terrible due to the Addison's not the synacthen test.

@Sparrowsandbudgies thanks for the link, it's strange that steroids can cause adrenal crisis, when steroids are also the treatment for Addisons.

@tinyspiny sorry to hear that, doesn't surprise me at all with the NHS tbh. I have some other autoimmune conditions and was totally fobbed off for years before diagnosis. Similarly, it was only after paying for private bloods that I got anywhere.

Steroids don’t cause an adrenal crisis directly - if used long term they can cause the body to stop sending the signals to make its own cortisol over time, this results in low cortisol. Untreated low cortisol can cause an adrenal crisis.

Ah, that makes sense. Thanks for the clarification.

I'm still waiting for the results. The nurse said Friday so will check with gp tomorrow afternoon if I don't hear anything.